Guideline

Closing a Practice

When physicians close their practices for reasons of retirement, relocation, or any other reason, they are obligated to make adequate provisions to minimize any impact on their patients. Similar terms apply to physicians who anticipate an extended absence from practice.

In that regard, the first priority is to provide adequate notice to patients who may be affected. Such should occur as soon as a physician can provide specific information as to when their services will no longer be available. The earlier this is done the better position patients will be in for pursuing alternate arrangements. Except in unusual circumstances, such notice should not be less than ninety days.

The specific patients which need to be notified depends on the circumstances. For family physicians, this generally involves all patients who are believed to be active. For specialists, notice should be given to any patients who are in active treatment, or would otherwise assume that the physician is available after the intended date of departure. This may include patients who have not yet seen the physician, but either have an appointment for consultation, or are expected to receive notice of one.

For specialist patients who are not in active treatment, but are seen, for example, annually, it may be sufficient to advise their family physician in order that other arrangements can be made.

For patients for whom notice must be given, the method of doing so should ensure that adequate information is provided. This should be by direct communication either through an office notice, a letter, or a telephone call. A newspaper advertisement, on its own, is generally not considered sufficient.

The departure of a physician may create more difficulty for some patients than others. Whether a patient of a family physician or a specialist, additional assistance may be necessary for those patients where any interruption in treatment would cause significant harm. For very selected patients, family physicians are encouraged to directly assist the patient in finding another physician. For patients of specialists in active treatment, direct referral to a qualified colleague is preferred as well. Similarly, patients who are expecting a consultation, or have been booked for surgery, should also be referred directly to a qualified colleague rather than necessitating a further consultation request from their family physicians.

It is also not appropriate, once a physician has determined they are leaving the practice, to accept any new referrals on patients for whom it is unlikely the expected services will be concluded by the time of departure.

If at all possible, physicians should ensure that adequate arrangement is made for any laboratory reports or other results which may need to be completed after the departure of the physician. If the physician has ordered an investigation, they remain responsible for ensuring that the patient is appropriately advised of the results.

Subject to prescribing guidelines, physicians should also endeavour to ensure adequate provision for ongoing prescriptions.

As discussed in the guideline on The Patient Medical Record, physicians are expected to ensure adequate retention, storage, and access to records following the closing of an office. Any communication to the patients should provide information on how their health records may be accessed.